health and social care essay

Reflective Journal And Case Study Health And Social Care Essay

Published: 23, March 2015

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Our discussion last Thursday and Friday focused on the Impact of Disease on Health Care Delivery System and Health & Social Care. During that time our tutor Kate gave us an activity which we will cite examples have disease affected those areas of health.

Due to our disserted topic I learned that once a disease happen get through in a community many problems will appear and needs to be solve immediately before it will get worst. To prevent it to happen, many organisation like WHO, DOH, UNICEF etc. made actions to control it but unfortunately still many problems coming up which was all explained by the groups.

Things like Financial Issues, Supply and Demands, Lack of Awareness and Knowledge, Skills Shortage and Poor compliance are the cited problems in all groups that occur in a community who are affected with any kinds of disease. We come up this idea of some reasons. Why Financial Issues? Because medicines and manpower are not free which means it needs funding to cope this problem especially when a large portion of individuals who are needed to be rendered with health services. Supply and Demands, still related to financial issues. Lack of Awareness and Knowledge, this contributes the problem because if a community is lack of awareness or knowledge about it health they are very vulnerable to illnesses or diseases. Skills Shortage this pertains to the members of health care system, it talks about how effective are they in rendering their services, are they professional and skilled to give services in an efficient and effective way??

Another topic we also considered last week was about case study of Philip, that study is very meaningful to us because its talks about Philips health and family problem. That case study gives us information that Health awareness is vital to a human life and we should take care of ourselves. It also

gives ideas to health practitioner on how to manage a case that has crucial situation and needs immediate attention.

Has this new knowledge changed my understanding? ( have I developed a whole new way of seeing things):

Knowing about the topic we tackled last week enlightened my mind on the importance of caring ourselves and a community as a health practitioner. Hearing those facts make me think that we should take care ourselves in many ways like having enough knowledge in health promotion and disease prevention, regular check up to assess our health status whether we are having illness or not, having healthy habit, diet and lifestyle.

On the other hand also as a health care provider it is our responsibility to provide health teaching on those individuals we know that needs it or even not because doing this promotes health and gives knowledge to them on avoiding any disease problems. In addition, we should be a role model of health to them because this is one of the effective way were they will believe our health teachings and apply it to their selves.

How will I apply this knowledge and understanding in my work situation?

In my situation, there are many cases where I can apply this facts and knowledge I gathered in our last week's discussion. As we know, we can encounter different case of diseases in care homes both communicable and non-communicable disease and we are aware that we're susceptible to have that diseases if we are not aware of it. Due to this point, precautions necessary to prevent getting and spread of one disease to another and we can do it by applying the things we discussed about public health in our workplace. In order to avoid ourselves and others from getting any disease we must maintain doing the basic things like hand washing after toileting/diapering, before preparing or eating food, after covering a sneeze or cough, after blowing the nose, before and after treating a sore or wound. Using of proper protective clothing as a first line of defence.

Learning a new topic leads to changes in our knowledge and understanding and should also lead to changes in ways of working.

Identify any new knowledge, facts or theories that I have learnt from this week's teaching:

Last week, We discussed all the things that are related about public health and itself. I found out that public health is a very broad topic and correlates many components such as health sector, health organisations, etc.

I learned that Public Health is vital in helping people to be aware about their health because it promotes good health, prolongs life and prevents society in getting any kind of diseases. It is also a gathered deed for the health of the certain population.

In dissemination of all the information related to health, there are agencies that are responsible in data distribution. This agencies and sectors are the one who takes the promotion, prevention, planning, action, and implementation of all the goals in regarding health information dissemination.

One of the most common agencies here in United Kingdom is the National Health Service or commonly called NHS. This agency acts as a framework of local organisations responsible for the healthcare of the community and to work with the local community to improve our populations health and well being. There are more agencies that acts or has a role like the NHS in relation to Public Health.

On the other hand Health Organisation has a big role in terms of promoting people in health awareness of the community because they are the one who distribute the health information globally such as World Health Organisation. WHO is the organisation that coordinates and directs for health within the United Nations. WHO leads in providing information about global health matters. Every time there is a new case of disease they are the one that conducts the studies on it and share the information all over the globe. For example, last week we had disserted the topic about the different infectious disease ( Swine Flu, Salmonella, HIV/AIDS, Measles, Meningitis, Tuberculosis , and MRSA ) and Non-infectious Disease ( Cancer, Coronary Heart Disease, Cerebro-Vascular Accident, Obesity, Asthma ) which are the products of the studios of WHO. Without WHO we cant gain access or unknowledgeable about these diseases.

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Has this new knowledge changed my understanding? (have I

developed a whole new way of seeing things)

The topic we discussed doesn't change my understanding about Public Health. The lesson we take up last week adds information about what I know in public health and it makes me understand that it is very important in building healthy community not only in a certain place but globally.

It also reminds me that as a health practitioner, we have also the responsibility to share what we have learned about promoting health and preventing diseases. Through this way we can help achieved one of the Public Health goal, which is the Health Awareness.

How will I apply this new knowledge and understanding in my work situation?

Like what I have said before, we can apply this knowledge by sharing the information about public health and telling them how to prevent diseases.

In my situation as an Health Care Assistant in a Care Home, I can share what I have learned by telling to all my colleague's the importance of using protective clothes whilst giving care to a service user and explaining them how to make care a service user who has infectious and non-infectious disease.

INTRODUCTION

In this assignment, for Part 1, I am going to cite two agencies and named their roles in Public Health in terms of identifying level of health and disease in communities. I will name also epidemiology of two diseases and investigate a chart or graphical form of its incident rate. On other hand I will show the Statistical Data of the two diseases and interpret it base on facts and my understanding.

In every agency I will choose two different approaches and strategies in controlling disease and investigate its effectiveness and after that I will make surveillance on how it improves Public Health. In this activity too I need to inspect current priorities to the provision of one disease and gives example on how it relates between prevalence rate, its causes and the requirements for health and social care services. Explore

In Part 2, I will do a case study on a given data or on a workplace experience. Analyse its critical factors that affects individual's health then after I am going to put its priorities and evaluate its effectiveness to individuals well being. I will proposed as well changes that can improve its health and set it in action like having implementing campaigns to encourage maximize their health.

In this part, I will explain the role of 2 different agencies in identifying levels of health and disease in communities

PUBLIC HEALTH

It is improving and safeguarding well-being. Public Health is in charge for health safety, health enhancement and health inequalities issues in England. It is responsible moreover for shaping policy, allocating resources, co-ordinating actions and supervising progress. Diagnose and investigate health hazards and health problems in the society. Assess accessibility, effectiveness, and quality of personal and population-based health services. In addition they are the one organised community efforts in aiming prevention of disease and promotion of health. In relation of this, I select two agencies that will partake the goals of public health.

There are many agencies that have important roles in the society. I chose two agencies which helps contribute health awareness and protection for any kind of diseases; it is the Department of Health (DOH) and National Health Services (NHS).

I will precisely relate this two agency to the two diseases I chose which is the Meningitis and Cerebrovascular Accident.

Department of Health has many roles for the society. This agency focuses on issues related to the general health of the citizenry. It also compiles statistics about health issues of their area. It assesses and assures risk management to human health from the environment properly. Promote and protect the health and wellness of the people within the society and community. Promote and protects the public health to prevent disease and illness. Provides research and information for the detection, reporting, prevention, and control of any diseases or health hazard that the department considers to be dangerous that likely affects the public health. Establish a uniform public health program throughout the community which includes continuous service, employment of qualified employees, and a basic program of disease control, vital and health statistics, sanitation, public health nursing, and other preventive heath programs necessary or desirable for the protection of public health. Gather and disseminate information on causes of injury, sickness, death, and disability and the risk factors that contribute to the causes of injury, sickness, death, and disability within the society for their awareness. Implement programs and campaigns necessary or desirable for the promotion or protection of the public health to reduce and control the disease. DOH develops strategic approaches for current health risks. Establish risk analysis framework and maintenance of risk standards.

http://www.le.utah.gov/interim/2005/pdf/00000306

National Health Services is a publicly funded healthcare systems in United Kingdom, this agency focus on maintaining people's health and well-being. This agency is responsible for delivering quality and effective health service to humanity. They also contribute fair access to everyone in relation to people's need. They are responsible for making payments to independent primary care contractors such as GPs, dentists, opticians and pharmacists in rendering their services to all people who needs it. It provides different caring services such as Emergency Respite Care, where care is provided if an individual; are unable to fulfil your caring responsibilities due to unforeseen circumstances, such as illness.Â Domiciliary Care, where somebody comes into your home and takes over some of your responsibilities for a few hours.Â Day care centre, where the person you care for spends time at a centre whilst you have a few spare hours to yourself. There are more services rendered by the NHS which develop societies health

In this part, I will investigate the epidemiology of two diseases in graph format and show my understanding and interpretation of the given data:

Meningitis is an infection of the meninges, protective membranes that surround the brain and spinal cord. Infection can cause the meningesÂ to become inflamed and swell, which can damage the nerves and brain. This can cause symptoms such as a severe headache, vomiting, high fever, stiff neck and sensitivity to light. Many people (but not all) also develop a distinctive skin rash.

Symptoms can differ in young children and babies. See the "symptoms" section for more information.

Meningitis can be caused by:

bacteria, such as streptococcus pneumoniae, the bacteria also responsible for pneumonia, which usually live harmlessly in your mouth and throat, and

viruses, such as the herpes simplex virus.

Viral meningitis

Viral meningitis is the most common and less serious type of meningitis. There are approximately 3,000 cases of viral meningitis reported in England and Wales every year, but experts believe the true number is much higher. This is because in many cases of viral meningitis the symptoms are so mild that they can often be mistaken for flu.

Viral meningitis is most common in young children and babies, especially in babies less than one year old.

Viral meningitis usually gets better by itself within a couple of weeks, without the need for specific treatment.

Bacterial meningitis

Bacterial meningitis is extremely serious and should be treated as a medical emergency.

If the bacterial infection is left untreated, it can cause severe damage to the brain and infect the blood (septicaemia), leading to death.

Treatment requires a transfer to an intensive care unit so the body's functions can be supported whilst antibiotics are used to fight the infection.

There are approximately 2,000 cases of bacterial meningitis in England and Wales every year. The number of cases has dropped sharply in recent years due to a successful vaccination programme that protects against many of the bacteria that can cause meningitis.

The treatment for bacterial meningitis has improved greatly. Several decades ago, almost all people with bacterial meningitis would die, even if they received prompt treatment. Now deaths occur inÂ one in 10 cases, usually as a result of a delay in treatment.

Bacterial meningitis is most common in children and babies under the age of three, and in teenagers and young people aged 15-24.

The best way to prevent meningitis is to ensure that your family's vaccinations are up to date.

Stroke (cerebrovascular accident)

A stroke happens when the blood supply to the brain is disturbed in some way. As a result, brain cells are starved of oxygen. This causes some cells to die and leaves other cells damaged.

Types of stroke

Most strokes happen when a blood clot blocks one of the arteries (blood vessels) that carries blood to the brain. This type of stroke is called an ischaemic stroke.

Transient ischemic attack (TIA) or 'mini-stroke' is a short-term stroke that lasts for less than 24 hours. The oxygen supply to the brain is quickly restored and symptoms disappear. A transient stroke needs prompt medical attention because it indicates a serious risk of a major stroke.

Cerebral thrombosis is when a blood clot (thrombus) forms in an artery that supplies blood to the brain. Blood vessels that are furred up with fatty deposits (atheroma) make a blockage more likely. The clot prevents blood flowing to the brain and cells are starved of oxygen.

Cerebral embolism is a blood clot that forms elsewhere in the body before travelling through the blood vessels and lodging in the brain. In the brain, it starve cells of oxygen. An irregular heartbeat or recent heart attack may make you prone to forming blood clots.

Cerebral haemorrhage is when a blood vessel bursts inside the brain and bleeds (haemorrhages). With a haemorrhage, blood seeps into the brain tissue and causes extra damage.

This graph table shows the effectiveness of meningococcal conjugate vaccine from 1998 - 2007. As we have seen in the figure, the case reduces every year especially to those who have taken the vaccine. It also shows the successful phased introduction of the meningococcal serogroup C conjugate vaccine (MCC) in 1999 into the National Immunisation Programme in the UK. This graph tells also that the immunity to Meningitis C has been identified in age groups who have not been vaccinated, as bacterium carriage rates are reduced across the population. We can see also in this table that those who didn't take meningococcal vaccine were greatly affective by Meningitis.

In this table, we could conclude that ages under 1-4 years old was greatly affected by meningitis as we have seen in the peaks of the graph and 0-11 months was greatly affected by the Pneumococcal and Meningococcal disease. And the same 'peaks' in the number of notifications for the 'under 4 years' and '15-24' age groups can also be seen with meningococcal septicaemia.

This graph shows the high number of notifications of meningococcal and pneumococcal meningitis (without septicaemia) in England and Wales. Observing this graph will note us that the cases in 2005, age group that is 1 year of age are greatly affected with Meningococcal Meningitis and Pneumococcal Meningitis and 15 to 24 years of age were averagely affected with the certain disease. It also illustrates us that among the group cases 'under 1 year of age' gets the highest peak in having Pneumococcal disease. It is also interesting to note that the pneumococcal meningitis peaks again in the older age groups (45-64 and 65+).

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This graph shows all the percentages of all six categories are experiencing stroke. Figures for males are in dark gray bars and data for females are in light gray bars, with the number of patients in each age category shown above each bar. All data are patients who are experiencing stroke or CVA. As we observed in the graph the age group from 30 to < 40 of males has the highest rate of experiencing stroke and in female is the age group whilst 50 to <60 is the utmost pace of age for females. 20 to <30 and 40 to <50 has the same rate in experiencing this disease. In female 30 to <40 and 50 to <60 is nearly same to each other having this disease.

This illustration shows the Incidence Rate of stroke in United States and United Kingdom. Details are articulated as person per year having stroke in 7 age categories. Individual experiencing strokes, person-years of follow-up was defined as the number of years from birth to the date for first recorded stroke. For individual without strokes, person-years of follow-up were defined as the last available follow-up date during the natural history period. Stroke incidence rates are revealed in data chart beneath the graph. As you see the data it's very clear that a UK male has the highest incidence rates. UK Females, US Males and US Females are mostly like has the same incidence rate in occurrence of CVA.

In this part, I will choose at least two approaches and strategies that control the incidence of one disease and analyse its effectiveness:

As prevention of these diseases and to decrease its rate Department of Health and National Health Services make strategies and campaign to attain their goals. Department of Health formulate the " Meningitis C Campaign " the purpose of the this campaign was to immunise as many as possible of the country's 15 million young people and children aged under the age of 18 years in as short a time as possible, immunising those most at risk of disease first.

Carrying out of the programme was made according to the risk of disease-those at utmost risk being immunised first. In November 1999, National Childhood Programme introduces the routine immunisation of vaccine at the ages of two, three and four months - alongside the DTP, Hib and polio vaccines and in December 1999 adolescent that ages 15 and 17 was also immunised.

As a result of the campaign there are around 13 million children have immunised during the first year through the help of general practitioners, nurses, immunisation coordinators and many other health professional.

This was pursuing by a widespread draw alongside programme to immunise all other children and adolescents up to the age of 18 years in 2000/2001.Â After that the vaccine was made accessible to anyone up to 25 years.

National Health Services contributed also a meningitis prevention program here in United Kingdom. The " Campaign to promote new Vaccine against Meningitis", this program encouraged all parents to immunised their children against pneumococcal disease which is the causative agent of meningitis. General Practitioners has the big role of this campaign because they are the who will catch-up the campaign for the children ages 0 - 2 years who is starting their immunisations. This program was imposed by Health Minister Dr. Brian Gibbons. He states that: "Immunisation is the best way to protect children from serious disease and the routine childhood programme has been extremely effective in achieving this. The changes will further improve the programme and benefit children. This new vaccine will help save lives and prevent hundreds more cases of serious illness such as meningitis and pneumonia."

To maximise the defence against Meningitis C and Hib disease NHS made two changes in the routine program. The present three doses of Meningitis C vaccine will be respaced at three and four months of age with a booster shot at 12 months.

Most up-to-date proof shows that the protection offered by this vaccine declines one year after vaccination. To maximise the protection in the first two years of life when the risk of infection is high, we will recommend doses at three and four months of age and a booster dose at 12 months. A booster shot of Hib vaccine will be given at 12 months.

In 1992 Hib vaccine was introduced and is presently given to children at two, three and four months of age. Since 1999, there was a small but slow increase in the number of cases in older children being reported. Again, because of this Meningitis prevention program, the disease declined over time. There was a Hib booster campaign happened in 2003. This dose was given to older children to maximise their immunity. This upturned the small increase in infections that had started to occur. A booster dose of Hib vaccine is being added to the childhood immunisation programme as a routine at 12 months to extend protection against Hib disease.

The new routine vaccination schedule is as follows:

2 months DTaP/IPV/Hib + pneumococcal vaccine

3 months DTaP/IPV/Hib + MenC vaccine

4 months DTaP/IPV/Hib + MenC + pneumococcal vaccine

12 months Hib/Men C

13 months MMR + pneumococcal vaccine

DTaP/IPV/Hib is a single injection that protects against diphtheria, tetanus, pertussis, polio and Hib.

MenC protects against meningitis C

Hib/ MenC is a combined vaccine protecting against Hib and Meningitis C

(2009)( Campaign to promote new Vaccine against Meningitis ) available from www.immunisation.nhs.uk. [Accessed at February 24, 2010]

Due to this campaign the rate of meningococcal infection has fallen every year since, and the cases of laboratory-confirmed group C meningococcal disease across all age groups immunised has go down by 90% since the vaccine was implemented. In 2003/04, there were only 65 cases reported and 8 deaths.

There was even a good effect in those who were not immunised with a reduction of about 70%, recommending that the vaccine has had a community protection effect.

In fact the campaign has been so successful that meningitis C disease now accounts for less than 10% of meningococcal meningitis cases. Even though the campaign made a great success still the health officials and medical professionals need to remain cautious.

(2010) ( Meningitis C Campaign) available from http://webarchive.nationalarchives.gov.uk. [Accessed at February 24, 2010]

The Stroke: Act F.A.S.T. awareness campaign aims to teach all health related professionals and the community on the signs of stroke and that prompt emergency treatment can reduce the risk of death and disability.

The campaign will notify the community about F.A.S.T. to call 999. F.A.S.T is a simple examination to help people to identify the signs of stroke and be aware of the importance of fast emergency management.

Campaign adverts, on Television, radio, internet and flyers, illustrate stroke 'spreading like fire in the brain' to demonstrate that fast emergency action can limit damage and radically raise a person's probability of surviving and of avoiding long-term disability.

If Department of Health has its campaign towards CVA, National Health Services provide also a program to lessen its incidence rate; The National Stroke Awareness Campaign. This campaign is related to F.A.S.T were NHS implemented that all paramedics should know how to assess a person using F.A.S.T before sending them to hospital.

They also made a Stroke Association who will support this campaign. This kind of charity is exclusively concerned with fighting stroke towards people in all ages. The charity resources research into prevention, treatment, better methods of rehabilitation and facilitates stroke patients and their families directly through its Rehabilitation and Support Services which include Communication Support, Family and Carer Support, information services, welfare grants, publications and leaflets.

In this part, I will investigate current priorities and approaches to the provision of heath services for people with one disease:

Treating Meningitis is not easy thing to do because this disease has various types, viral and bacterial meningitis. There is no treatment for Viral Meningitis. The immune system, will create antibodies to annihilate the virus. Until it is known that a child has viral, not bacterial meningitis, he or she will be admitted to the hospital. But once the finding of viral meningitis is complete, antibiotics are stopped, and a child who is recuperating satisfactorily will be sent home.

Simply acetaminophen must be given to lessen fevers. Clear fluids and a bland diet including preferred foods should be offered. During recovery, a child desires rest in a gloomy, quiet room. Bright lights, noise and guests may irritate a child with meningitis. Increased anxiety on the brain from build-up of fluid in the meninges is a severe problem.

(2010)(Viral Meningitis) available from: http://www.healthscout.com. [Accessed at February 24, 2010)

For Bacterial Meningitis may prove fatal within hours. Patients with suspected acute bacterial meningitis should be immediately admitted to the hospital and assessed for whether LP (lichen planus) is clinically safe. Antimicrobials should be given quickly. If LP is late because a CT scan is essential, antibiotic action should be started before the scan and after blood samples have been attained for culture. When the exact organism is recognized and results of susceptibilities are known, treatment can be customized accordingly. After the diagnosis has been confirmed (generally within 12-48 hours of admission to the hospital), the patient's antimicrobial therapy can be modified according to the causative organism and its susceptibilities. Supportive therapy, such as fluid replacement, should be continued. Dexamethasone should be continued for Streptococcus pneumoniae, Haemophilus influenzae, and Neisseria meningitides.

In this part, I will explain by giving examples, the relationship between the prevalence of one disease, its causes and the requirements for health and social care services:

Nowadays United Kingdom is still cautious about Meningitis even though the incidence rate is already decreasing radically. To be safe, health organisation are prioritising women and children's health. They develop a guideline which suggest about management of bacterial meningitis and meningococcal septicaemia in children.

There are stakeholders moreover helped in enhancing the scope of this project and after the appointment of the guideline development group, they will make a series of questions all about clinical importance that covers the guideline of the scope which includes diagnosis of bacterial meningitis and meningococcal septicaemia, management of suspected bacterial meningitis and meningococcal septicaemia in primary care and the in the pre-hospital setting, management of bacterial meningitis and meningococcal septicaemia in secondary care, retrieval and transfer to secondary and tertiary care, choice and timing of investigations, information that should be given to parents and carers.

This two graph shows the high number of notifications of meningococcal and pneumococcal meningitis (without septicaemia) cases in the 'less than 4 years' and '15-24 years' age groups. It also illustrates that case within the 'less than 4 years' age group peak at 'less than 1 years'. It is also interesting to note that the pneumococcal meningitis peaks again in the older age groups (45-64 and 65+). As what you can see here in the prevalence rate of bacterial meningitis (without septicaemia), it is very clear that the mostly affected with this disease is the Serogroup Group B, it has the highest rate with 88% above the 4 category.

Â

Confirmed meningococcal infections by region weeks 2008-49 to 2009-02

Â

Serogroup B

Other serogroups

Total confirmed cases

East Midlands

17

-

17

Eastern

26

2

28

London

23

3

26

North East

14

2

16

North West

52

4

56

South & West

27

4

31

South East

26

1

27

West Midlands

32

8

40

Yorkshire & Humberside

35

6

41

Total

252

30

282

Â Meningococcal serogroup B infections in England

A clear increase in reports of Neisseria meningitides serogroup B infections has been observed during December 2008 and early January 2009. The number of cases reported during December and early January (week 2008-49 to week 2009-02), however, is substantially higher (252) than the same period during any of the previous three years (198, 142, and 191). Cases are disseminated across England. The provisional sum number of meningococcal serogroup B infections all through 2008 was 1070, similar to the annual totals for 2007 (1076) and 2006 (1011).

Generally the number of confirmed meningococcal cases remains low down with only 1194 confirmed cases in 2008, lower than 2007 (1256) and continuing the overall descending trend since 1999/2000. A main involvement to the overall reduction has been the sustained fall in serogroup C cases following the introduction of meningococcal serogroup C conjugate vaccine in 1999. Only 22 cases of serogroup C infection were confirmed last year, compared to 989 cases in 1999. Serogroup B infections have in the past shown repeated fluctuations, often linked to the flow of precise strains. The boost observed during December 2008 and early January 2009 appears to be connected with a range of serogroup B organisms.

This graph as well shows that the Public Health in this time doesn't have enough any knowledge about the disease and unable to treat those affected with the illness. Due to this reason health organisation that is related with this problem requires to conduct more study and research on how to cure or treat not only the category above that has the highest rate of this disease and prone to have more mortality and morbidity rate but all of all category that is affected with the disease. They need also to do more campaigns, strategies and approaches to fight with it, this so called provisioning. Health care system should keep an eye to this disease to comply community's needs. This is a challenge for them to make and manage clinical services more reliable to all individuals. Health care provisioning key must address both efficiency and fulfilment to all individuals.

In this part, I will analyse the impact of two current lifestyle choices on futute needs for health and social care services:

Every individual can choose their own lifestyle but unfortunately some of them don't know what its effect on their health, some as well knows its bad effects but they're keeping doing it because they tend to reason out that it is connected to their life and they can't live without it. Like in my assignment Cerebral Vascular Accident, this disease can be related on our lifestyle for example Substance Abuse, drinking too much alcohol increases the risk CVA, drinking too much alcohol can raise blood pressure because it makes our blood viscous, that may cause heart failure and it will lead to stroke. It raises also our body's triglycerides that may produce irregular heartbeats. It also contributes to obesity which means if a person is obese they are more potential to have stroke. The risk of heart disease in people who drink moderate amounts of alcohol is lower that non-drinkers. Normally a individual can only have 1-1/2 fluid ounces (fl oz) of 80-proof spirits (such as bourbon, Scotch, vodka, gin, etc.), 1 fl oz of 100-proof spirits, 4 fl oz of wine, or 12 fl oz of beer or alcohol to have healthy drinking lifestyle.

Another lifestyle that may lead individual to the need of social service in the future that is related in stroke is Excessive Cigarette Smoking. Cigarette Smoking is widespread and significant as a risk factor that the general surgeon has called it "the leading preventable cause of disease and deaths." Cigarette smoking increases the risk of coronary heart disease by itself. When it acts with other factors, it greatly increases risk. Smoking increases blood pressure, decreases exercise tolerance and increases the tendency for blood to clot that's why it can cause cerebral vascular accident. The nicotine and carbon monoxide in cigarette smoke damage the cardiovascular system in many ways which contributes the cerebral vascular accident to happen. Smoking also increases the risk of recurrent coronary heart disease after bypass surgery because as we have know that smoking can make our blood viscous and of this there is a big possibility that the stent that was putted in affected vessel will be removed and may cause more blockage. Cigarette smoking is the most important risk factor for young men and women especially nowadays minors smoke cigarette and overdo it. It also produces a greater relative risk in persons under age 50 than in those over 50.Women who smoke and use oral contraceptives greatly increase their risk of coronary heart disease and stroke compared with non-smoking women who use oral contraceptives. Smoking decreases High Density Lipoproteins (good cholesterol.) Cigarette smoking combined with a family history of heart disease also seems to greatly increase the risk.

In this part, I will investigate the range of services required to support individuals affected by one disease in a local community:

Meningitis causes widespread alarm in all communities. To support community in battling with Meningitis Public Health team including Cambridge Crystallographic Data Centre (CCDC), Consultants in Public Health Medicine (CPHM), Advance Health Optics (AMO) provides a 24 hour helpline all over United Kingdom because Department of Health put Meningitis as one of the most feared illness by parents and second highest incidence rate in Europe.

Due to this outbreak Meningitis Research Foundation works directly with Public Health Teams this is to ensure that people have full and accurate information without causing unnecessary fears with this disease. They also made a leaflet titled "Meningococcal Meningitis and Septicaemia - Am I at Risk?" to inform the community and become aware with it.

The aim of this leaflet is to allay unfounded fears about meningococcal disease by helping people understand the level of risk, and answering frequently asked questions about the diseases; and clearly illustrates the different symptoms of meningitis and septicaemia, the rashes of meningococcal disease and the tumbler test.

Am I at Risk was developed through consultation with CCDCs and CPHMs as well as paediatricians and representatives of the Department of Health, The Royal College of General Practitioners, The British Medical Association and the Office for Health Gain.

Many public health doctors routinely include this leaflet with letters that are sent home to parents when dealing with a case in a school or nursery. For many parents, the messages about levels of risk and the reassurance of having symptoms information close to hand help to allay their fears.

24 helpline is a helpline where community can call anytime; it is operated by trained and qualified staff nurse to speak to callers who needs information about this disease and to those who has questions about disease night and day. This will provide as well information for people concerned about meningitis and septicaemia.

In this part of the assignment I will now discuss a case study regarding sexually transmitted disease among teenagers. The case study as it follows:

"Sandy Jones is 19 years old and has been seeing her boyfriend for 6 months. They are now sexually active. She has made an appointment with her GP because she has developed signs of a sexually transmitted disease which has been confirmed following investigation (the public issue you need to consider is sexually transmitted diseases)"

In this case we need to suggested Sandy Jones to have an appointment to her general practitioner and discussed its problem for her safety. She needs also health teaching a need to be informed that she can transmit the disease she carries, telling this to her can prevent the disease to spread. Discussing her problem to her GP prevent also future problems and lucky to her because she's aware that she acquired sexually transmitted disease because some STD's has no symptoms and being not aware of it will lead to major health problems such as not being able to get pregnant (infertility), permanent brain damage, heart disease, cancer, and even death. That's why, if we think you have been exposed to a sexually transmitted disease, you and your sex partner(s) should visit a health clinic, hospital or doctor for testing and treatment. We need also to prioritize her needs; we know that she's sexually active so sex is the 1st priority because based on Maslow's Hierarchy of Need this belongs to physiologic needs. This is why we need to her to teach about sex and how to make it in safety way. 2nd (safety and security) is her safety which I already discussed above. Third one (love and belongingness) is her emotional needs, based on her case she doesn't have family or any relatives to talk with her problems and she doesn't have parents to guide her. Fourth (self-esteem), we need to place her case on private because her case may decrease her reputation if anybody will know about her status and the last (self-actualisation), to have this one she needs to be mature and know all the results of her action but there still should be a guidance for her.

In this part, I will critically evaluate the effectiveness of strategies, systems, and policies in the setting for maximizing the well being individuals:

There are plenty of programs that are related about sex, sex education and its effects that the United Kingdom government provided and implemented already. One of this and the most common is "Sex Education that Works" this program from the government aims to educated teenagers about sex. It is also a process of obtaining data, forming attitudes and beliefs towards sex, sexual identity, intimacy and relationship. Sex education is also about budding young people's abilities that they formulate informed choices about their manners, and think positive and proficient about acting on these choices. It is generally accepted that young people have a right to sex education.

"Teacher Training", Good pre-service and in-service is essential for teachers if curricula on sexual and reproductive health, including HIV/AIDS, are to be effective.Â Such training presents many challenges but is essential to help young people learn more about their sexuality and how to avoid unplanned pregnancy and sexually transmitted infections.

In most schools, sexual and reproductive health education consists of didactic lectures about basic anatomy and physiology. This is hardly surprising, because most training programs fail to prepare future teachers of sexual and reproductive health to teach the subject effectively. As a result, many teachers complete their training with critical gaps in their knowledge of reproductive health. Some have judgmental attitudes or religious, legal or moral objections to teaching young people about sex, contraception, or condom use. Others feel uncomfortable talking about such subjects or using the interactive teaching methods that appear to be most effective in promoting healthy sexual behaviour. When they move to the classroom, these teachers are often expected to use teaching materials that omit key information and encourage the "chalk and talk" approach.

Research has shown that widespread sex education benefits young adults significantly. These programs support teenagers deal with peer pressure and educate them the art of communication and negotiation. It assists them with imbibing self-confident skills, essential in their dealings with peers.

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